An Evaluation of Telemedical Support for a Minor Treatment Centre

Abstract

A low-cost telemedicine link was established from an accident and emergency department in Belfast to support nurse practitioners running a minor treatment centre (MTC) in London. During the 12 months before the introduction of the telemedicine link, 6729 patients were seen in the MTC. Of these, 155 (2.3%) were referred to the nearest accident and emergency department and 802 (11.9%) were referred to their general practitioner (GP). During the first 12 months of the use of the telemedicine link, 9972 patients were seen in the MTC. Of these, 147 (1.5%) were referred to the accident and emergency department and 383 (3.8%) were referred to their GP. During the evaluation period, 51 patients were seen using the telemedicine link, representing 0.5% of all MTC attenders during that period. The total number of teleconsultations was less than expected. The reasons for this difference include random variation, but could also include confidence resulting from the presence of the link and a training effect. The telemedicine link for trauma and minor injuries was an extremely cost-effective way of providing medical expertise to cover the clinical risk of the 0.5-1.5% of the case load that required expert medical opinion. The direct costs of on-site medical staff would have been 50,000 pounds per annum, excluding overhead charges. The annual cost of the videolink, including overheads, was 7250 pounds, amounting to a saving of some 42,000 pounds per annum.

Evaluation of telemedical orthopaedic specialty support to a minor accident and treatment service

“…Our system is inferior to the standards laid down by the American College of Radiology but the accident and emergency and orthopaedic consultants were clear that the purpose of the teleconsultation was to arrive at a working diagnosis and achieve a safe clinical outcome. Other workers have reached similar conclusions [9][10][11][12] . Even desktop teleradiology in support of rural orthopaedic trauma care 13 showed 'no statistically significant differences between modalities in orthopedic residents' ability to correctly diagnose orthopedic trauma injuries'.…”

Interplay of cost and adoption of tele-medicine in Sub-Saharan Africa: The case of tele-cardiology in Ethiopia

“…The bank interest was 5% of the total investment cost based on the Ethiopian investment rule for health. The startup and training cost was evenly divided between seven and ten years respectively (See Annex I and III for detail) (Jennett et al, 2003;CCOHTA, 2003;Darkins et al, 1996).…”

A framework for the economic evaluation of telemedicine

“…In addition, it is inevitable that the role of the practice nurse will be transformed. Telemedicine technology has the potential to empower the remote nurse practitioner to conduct a greater variety of tasks under supervision from the advising clinician 9,10 . It may be the case that the skill mix will change, resulting in less need for qualified medical personnel at the remote end of a consultation, hence increasing the role for the telemedicine nurse and/or other medical personnel.…”